A Prospective, Population-Based Study of Trends in Operative Vaginal Delivery Compared to Cesarean Delivery Rates in Low- and Middle-Income Countries, 2010-2016

Margo S. Harrison, Sarah Saleem, Sumera Ali, Omrana Pasha, Elwyn Chomba, Waldemar A. Carlo, Ana L. Garces, Nancy F. Krebs, K. Michael Hambidge, Shivaprasad S. Goudar, S. M. Dhaded, Bhala Kodkany, Richard J. Derman, Archana Patel, Patricia L. Hibberd, Fabian Esamai, Edward A. Liechty, Antoinette Tshefu, Adrien Lokangaka, Melissa Bauserman & 10 others Carl L. Bose, Fernando Althabe, Jose M. Belizan, Pierre Buekens, Janet L. Moore, Dennis D. Wallace, Menachem Miodovnik, Marion Koso-Thomas, Elizabeth M. McClure, Robert L. Goldenberg

Research output: Contribution to journalArticle

Abstract

Objective Few data are available on cesarean delivery and operative vaginal delivery trends in low- and middle-income countries. Our objective was to analyze a prospective population-based registry including eight sites in seven low- and middle-income countries to observe trends in operative vaginal delivery versus cesarean delivery rates over time, across sites. Study Design A prospective population-based study, including home and facility births among women enrolled from 2010 to 2016, was performed in communities in Argentina, Democratic Republic of Congo, Guatemala, India, Kenya, Pakistan, and Zambia. Women were enrolled during pregnancy and delivery outcome data were collected. Results We analyzed 354,287 women; 4,119 (1.2%) underwent an operative vaginal delivery and 45,032 (11.2%) delivered by cesarean. Across all sites with data for 7 years, rates of operative vaginal delivery decreased from 1.6 to 0.3%, while cesarean delivery increased from 6.4 to 14.4%. Similar trends were seen when individual country data were analyzed. Operative vaginal delivery rates decreased in both hospitals and clinics, except in the hospital setting at one of the Indian sites. Conclusion In low- and middle-income countries, operative vaginal delivery is becoming less utilized while cesarean delivery is becoming an increasingly common mode of delivery.

Original languageEnglish (US)
Pages (from-to)730-736
Number of pages7
JournalAmerican journal of perinatology
Volume36
Issue number7
DOIs
StatePublished - Jan 1 2019
Externally publishedYes

Fingerprint

Population
Guatemala
Zambia
Democratic Republic of the Congo
Kenya
Pakistan
Argentina
Pregnancy Outcome
Registries
India
Parturition

Keywords

  • cesarean delivery
  • facility-based delivery
  • low- and middle-income countries
  • mode of delivery
  • operative vaginal delivery

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynecology

Cite this

A Prospective, Population-Based Study of Trends in Operative Vaginal Delivery Compared to Cesarean Delivery Rates in Low- and Middle-Income Countries, 2010-2016. / Harrison, Margo S.; Saleem, Sarah; Ali, Sumera; Pasha, Omrana; Chomba, Elwyn; Carlo, Waldemar A.; Garces, Ana L.; Krebs, Nancy F.; Hambidge, K. Michael; Goudar, Shivaprasad S.; Dhaded, S. M.; Kodkany, Bhala; Derman, Richard J.; Patel, Archana; Hibberd, Patricia L.; Esamai, Fabian; Liechty, Edward A.; Tshefu, Antoinette; Lokangaka, Adrien; Bauserman, Melissa; Bose, Carl L.; Althabe, Fernando; Belizan, Jose M.; Buekens, Pierre; Moore, Janet L.; Wallace, Dennis D.; Miodovnik, Menachem; Koso-Thomas, Marion; McClure, Elizabeth M.; Goldenberg, Robert L.

In: American journal of perinatology, Vol. 36, No. 7, 01.01.2019, p. 730-736.

Research output: Contribution to journalArticle

Harrison, MS, Saleem, S, Ali, S, Pasha, O, Chomba, E, Carlo, WA, Garces, AL, Krebs, NF, Hambidge, KM, Goudar, SS, Dhaded, SM, Kodkany, B, Derman, RJ, Patel, A, Hibberd, PL, Esamai, F, Liechty, EA, Tshefu, A, Lokangaka, A, Bauserman, M, Bose, CL, Althabe, F, Belizan, JM, Buekens, P, Moore, JL, Wallace, DD, Miodovnik, M, Koso-Thomas, M, McClure, EM & Goldenberg, RL 2019, 'A Prospective, Population-Based Study of Trends in Operative Vaginal Delivery Compared to Cesarean Delivery Rates in Low- and Middle-Income Countries, 2010-2016', American journal of perinatology, vol. 36, no. 7, pp. 730-736. https://doi.org/10.1055/s-0038-1673656
Harrison, Margo S. ; Saleem, Sarah ; Ali, Sumera ; Pasha, Omrana ; Chomba, Elwyn ; Carlo, Waldemar A. ; Garces, Ana L. ; Krebs, Nancy F. ; Hambidge, K. Michael ; Goudar, Shivaprasad S. ; Dhaded, S. M. ; Kodkany, Bhala ; Derman, Richard J. ; Patel, Archana ; Hibberd, Patricia L. ; Esamai, Fabian ; Liechty, Edward A. ; Tshefu, Antoinette ; Lokangaka, Adrien ; Bauserman, Melissa ; Bose, Carl L. ; Althabe, Fernando ; Belizan, Jose M. ; Buekens, Pierre ; Moore, Janet L. ; Wallace, Dennis D. ; Miodovnik, Menachem ; Koso-Thomas, Marion ; McClure, Elizabeth M. ; Goldenberg, Robert L. / A Prospective, Population-Based Study of Trends in Operative Vaginal Delivery Compared to Cesarean Delivery Rates in Low- and Middle-Income Countries, 2010-2016. In: American journal of perinatology. 2019 ; Vol. 36, No. 7. pp. 730-736.
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abstract = "Objective Few data are available on cesarean delivery and operative vaginal delivery trends in low- and middle-income countries. Our objective was to analyze a prospective population-based registry including eight sites in seven low- and middle-income countries to observe trends in operative vaginal delivery versus cesarean delivery rates over time, across sites. Study Design A prospective population-based study, including home and facility births among women enrolled from 2010 to 2016, was performed in communities in Argentina, Democratic Republic of Congo, Guatemala, India, Kenya, Pakistan, and Zambia. Women were enrolled during pregnancy and delivery outcome data were collected. Results We analyzed 354,287 women; 4,119 (1.2{\%}) underwent an operative vaginal delivery and 45,032 (11.2{\%}) delivered by cesarean. Across all sites with data for 7 years, rates of operative vaginal delivery decreased from 1.6 to 0.3{\%}, while cesarean delivery increased from 6.4 to 14.4{\%}. Similar trends were seen when individual country data were analyzed. Operative vaginal delivery rates decreased in both hospitals and clinics, except in the hospital setting at one of the Indian sites. Conclusion In low- and middle-income countries, operative vaginal delivery is becoming less utilized while cesarean delivery is becoming an increasingly common mode of delivery.",
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T1 - A Prospective, Population-Based Study of Trends in Operative Vaginal Delivery Compared to Cesarean Delivery Rates in Low- and Middle-Income Countries, 2010-2016

AU - Harrison, Margo S.

AU - Saleem, Sarah

AU - Ali, Sumera

AU - Pasha, Omrana

AU - Chomba, Elwyn

AU - Carlo, Waldemar A.

AU - Garces, Ana L.

AU - Krebs, Nancy F.

AU - Hambidge, K. Michael

AU - Goudar, Shivaprasad S.

AU - Dhaded, S. M.

AU - Kodkany, Bhala

AU - Derman, Richard J.

AU - Patel, Archana

AU - Hibberd, Patricia L.

AU - Esamai, Fabian

AU - Liechty, Edward A.

AU - Tshefu, Antoinette

AU - Lokangaka, Adrien

AU - Bauserman, Melissa

AU - Bose, Carl L.

AU - Althabe, Fernando

AU - Belizan, Jose M.

AU - Buekens, Pierre

AU - Moore, Janet L.

AU - Wallace, Dennis D.

AU - Miodovnik, Menachem

AU - Koso-Thomas, Marion

AU - McClure, Elizabeth M.

AU - Goldenberg, Robert L.

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Objective Few data are available on cesarean delivery and operative vaginal delivery trends in low- and middle-income countries. Our objective was to analyze a prospective population-based registry including eight sites in seven low- and middle-income countries to observe trends in operative vaginal delivery versus cesarean delivery rates over time, across sites. Study Design A prospective population-based study, including home and facility births among women enrolled from 2010 to 2016, was performed in communities in Argentina, Democratic Republic of Congo, Guatemala, India, Kenya, Pakistan, and Zambia. Women were enrolled during pregnancy and delivery outcome data were collected. Results We analyzed 354,287 women; 4,119 (1.2%) underwent an operative vaginal delivery and 45,032 (11.2%) delivered by cesarean. Across all sites with data for 7 years, rates of operative vaginal delivery decreased from 1.6 to 0.3%, while cesarean delivery increased from 6.4 to 14.4%. Similar trends were seen when individual country data were analyzed. Operative vaginal delivery rates decreased in both hospitals and clinics, except in the hospital setting at one of the Indian sites. Conclusion In low- and middle-income countries, operative vaginal delivery is becoming less utilized while cesarean delivery is becoming an increasingly common mode of delivery.

AB - Objective Few data are available on cesarean delivery and operative vaginal delivery trends in low- and middle-income countries. Our objective was to analyze a prospective population-based registry including eight sites in seven low- and middle-income countries to observe trends in operative vaginal delivery versus cesarean delivery rates over time, across sites. Study Design A prospective population-based study, including home and facility births among women enrolled from 2010 to 2016, was performed in communities in Argentina, Democratic Republic of Congo, Guatemala, India, Kenya, Pakistan, and Zambia. Women were enrolled during pregnancy and delivery outcome data were collected. Results We analyzed 354,287 women; 4,119 (1.2%) underwent an operative vaginal delivery and 45,032 (11.2%) delivered by cesarean. Across all sites with data for 7 years, rates of operative vaginal delivery decreased from 1.6 to 0.3%, while cesarean delivery increased from 6.4 to 14.4%. Similar trends were seen when individual country data were analyzed. Operative vaginal delivery rates decreased in both hospitals and clinics, except in the hospital setting at one of the Indian sites. Conclusion In low- and middle-income countries, operative vaginal delivery is becoming less utilized while cesarean delivery is becoming an increasingly common mode of delivery.

KW - cesarean delivery

KW - facility-based delivery

KW - low- and middle-income countries

KW - mode of delivery

KW - operative vaginal delivery

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